1. Take the Meningitis Quiz
2. View the Ear Infection Slideshow
3. Childhood Illnesses Parents Should Know

Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Bacteria and viruses cause the great majority of meningitis disease in infants and children. The most serious occurrences of meningitis are caused by bacteria; viral-caused meningitis is common but usually is less severe and, except for the very rare instance of rabies infection, almost never lethal. However, both bacterial and viral types of the disease are contagious.

Meningitis normally occurs as a complication from an infection in the bloodstream. A barrier (called the blood-brain barrier) normally protects the brain from contamination by the blood. Sometimes, infections directly decrease the protective ability of the blood-brain barrier. Other times, infections release substances that decrease this protective ability.

Once the blood-brain barrier becomes leaky, a chain of reactions can occur. Infectious organisms can invade the fluid surrounding the brain. The body tries to fight the infection by increasing the number of white blood cells (normally a helpful immune system response), but this can lead to increased inflammation. As the inflammation increases, brain tissue can start swelling and blood flow to vital areas of the brain can decrease.

Meningitis can also be caused by the direct spread of a nearby severe infection, such as an ear infection (otitis media) or a nasal sinus infection (sinusitis). An infection can also occur any time following direct trauma to the head or after any type of head surgery. Usually, the infections that cause the most problems are due to bacterial infections.

• Bacterial meningitis can be caused by many different types of bacteria. Certain age groups are predisposed to infections of specific types of bacteria.
• Immediately after birth, bacteria called group B Streptococcus, Escherichia coli, and Listeria species are the most common.
• After approximately 1 month of age, bacteria called Streptococcus pneumoniae, Haemophilus influenzae type B (Hib), and Neisseria meningitidis are more frequent. The widespread use of the Hib vaccine as a routine childhood immunization has dramatically decreased the frequency of meningitis caused by Hib.
• Viral meningitis is much less serious than bacterial meningitis and frequently remains undiagnosed because its symptoms are similar to the common flu. The frequency of viral meningitis increases slightly in the summer months because of greater exposure to the most common viral agents, called enteroviruses.

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